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Mayer-Davis EJ, D'Agostino, Jr R, Karter AJ, et al. Intensity and Amount of Physical Activity in Relation to Insulin Sensitivity: The Insulin Resistance Atherosclerosis Study. JAMA. 1998;279(9):669–674. doi:10.1001/jama.279.9.669
From the Department of Epidemiology and Biostatistics, School of Public Health, University of South Carolina, Columbia (Dr Mayer-Davis); Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (Dr D'Agostino); Division of Research, Kaiser Permanente, The Permanente Medical Group Inc, Oakland, Calif (Dr Karter); Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio (Dr Haffner); Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver (Dr Rewers); and the Departments of Medicine (Dr Saad) and Physiology and Biophysics (Dr Bergman), University of Southern California Medical Center, Los Angeles.
Context.— Exercise training is associated with improved insulin sensitivity (SI), but the potential impact of habitual, nonvigorous activity is uncertain.
Objective.— To determine whether habitual, nonvigorous physical activity, as well
as vigorous and overall activity, is associated with better SI.
Design.— A multicultural epidemiologic study.
Setting.— The Insulin Resistance Atherosclerosis Study, conducted in Oakland,
Calif; Los Angeles, Calif; the San Luis Valley, Colo; and San Antonio, Tex.
Participants.— A total of 1467 men and women of African American, Hispanic, and non-Hispanic
white ethnicity, aged 40 to 69 years, with glucose tolerance ranging from
normal to mild non–insulin-dependent diabetes mellitus.
Main Outcome Measure.— Insulin sensitivity as measured by an intravenous glucose tolerance
Results.— The mean SI for individuals who participated in vigorous
activity 5 or more times per week was 1.59 min−1·µU−1·mL−1·10−4 (95%
confidence interval [CI], 1.39-1.79) compared with 0.90 (95% CI, 0.83-0.97)
for those who rarely or never participated in vigorous activity, after adjusting
for potential confounders (P<.001). When habitual
physical activity (estimated energy expenditure [EEE]) was assessed by 1-year
recall of activities, the correlation coefficient between SI and
total EEE was 0.14 (P<.001). After adjustment
for confounders, vigorous and nonvigorous levels of EEE (metabolic equivalent
levels ≥6.0 and <6.0, respectively) were each positively and independently
associated with SI (P≤.01 for each).
The association was attenuated after adjustment for the potential mediators,
body mass index (a measure of weight in kilograms divided by the square of
the height in meters), and waist-to-hip ratio. Results were similar for subgroups
of sex, ethnicity, and diabetes.
Conclusions.— Increased participation in nonvigorous as well as overall and vigorous
physical activity was associated with significantly higher SI.
These findings lend further support to current public health recommendations
for increased moderate-intensity physical activity on most days.
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